Individual
AMANDA GIBBONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15 SAUNDERS WAY STE 900, WESTBROOK, ME 04092-4836
(207) 878-9663
(207) 878-2259
Mailing address
15 SAUNDERS WAY STE 900, WESTBROOK, ME 04092-4836
(207) 878-9663
(207) 878-2259
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
ST2839
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ST2839
STATE OF MAINE
ME
Enumeration date
07/11/2018
Last updated
07/11/2018
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